Gaunt Face Solution?

Do you recommend perlane or restylane for a more natural look in the cheeks to fix gaunt features?

Doctor Answers 18

Fillers for gaunt cheeks

Sculptra and Radiesse are possible fillers or filling deep areas, and in fact are FDA approved for deep filling in patients with HIV lipoatrophy. We don't use them because of its reactivity, but it is a very accepted way of filling deep areas.

fat injection is also a possibility, but those of you who have read my previous posts on the subject know my concerns about variability and lumpiness and the reasons these occur.

Restylane, Perlane and Juvederm (I prefer J-derm Ultra Plus) are thicker hyaluronic acid fillers that are also very good for filling deeper layers, although they do not last as long, but are not associated with the granulomatous problems of semipermanent fillers.

Patients with significant gauntness may also consider custom cheek implants, a surgery but of great benefit to patients who don't want to return repeatedly for fillers.

We prefer to fill the areas permanently with LiveFill(R), nontraumatized fat-fascial grafts placed in strategic pockets.

We have documented the survival of LiveFill on 3-dimensional CT scans and presented the results. The retention of soft, pliable tissue is excellent with normal appearance on microscopic examination. Patients do not have the up and down effect of temporary fillers. All patients n the before-after gallery had their results with a single LiveFill procedure.

So many options, all depending on the patient's needs.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 178 reviews

Radiesse, Sculptra and Artefill do good for gaunt faces

Perlane and restylane won't last very long. I tend to use Radiesse ($630/syringe) which lasts about 1 year or Artefill ($1200/syringe) which lasts 4-5 years. I don't have experience with Sculptra but others say it works well but tends to get alittle bumpy. Fat injections last 6 months to a year or more but gets lumpy when they start to go away and run about $2500 per session.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 43 reviews

Solutions for a gaunt face

Restylane is an excellent injectable, which we prefer over Perlane for placement in the nasolabial fold. Gaunt features are typically addressed through surgical procedures such as cheek augmentation and/or fat grafting.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Best filler for gaunt face

There are a few products that would work to fill a "gaunt face." Radiesse, which is a calcium based filler would work, however, the results only last 9-12 months. Sculptra, which is a collagen stimulant is a great solution. It does, however, take multiple treatments but can last up to 2-3 years. Each one has it's benefits and in order to determine the best one for you it would be best to schedule a consultation with a cosmetic dermatologist.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.6 out of 5 stars 22 reviews

Sculptra is a better choice for restoring facial volume

Dermal fillers like Restylane or Juvederm can be used to volumize one's face but Sculptra provides a much longer result.  It does take a couple treatments to reach full effect but it is a very natural process and patient's love the results.

Thanks for the question!

Steven E. Rasmussen, MD, FAAD
Austin Dermatologist
5.0 out of 5 stars 3 reviews

Volumizing gaunt cheeks with fillers

Hyaluronic acids such as Restylane or Juvederm Ultra are not designed for volumizing any significant fat loss. Perlane, a thicker form of Restylane or Juverderm Ultra Plus can be used. Radiesse is a good filler for this purpose. Sculptra is a "seed" rather than an immediate filler. It stimulates your own body's collagen formation. Several sessions are required, several weeks apart.

Gaunt cheeks can be volumized with fat injections if there is enough fat that we can find on you. Fat injections act as grafts. Some work well and live in their new environment, while other fat injections don't seem to take.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Fillers for gaunt face

Although many fillers can be used, particularly thin faces seem to get the best, most natural restoration with Sculptra. The results are gradual in onset, require 2 to 3 sessions several months apart, but will last 2 to 3 years.

Stephen Mandy, MD
Miami Dermatologic Surgeon
4.3 out of 5 stars 6 reviews

Correcting the gaunt midface

There are several options for improving the midface with fillers. You can use restylane, juvederm, or perlane but it typically requires larger amounts of those fillers and hyaluronic acid fillers in the midface below the skin typically does not last very long. Other options include radiesse which has been purported to last about 14 months or so but that is variable as well.

My personal preference is sculptra which takes multiple treatments but can last three years or more. There is another filler called Artefill which is permanent but there are no long term studies to show how long the cosmetic effect lasts for volumizing the midface. I hope this information helps.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Radiesse for a gaunt face

I routinely use Radiesse to volumize the face and improve an aged, gaunt appearance. I think in this case, Radiesse would most likely give a better filling result than either Restylane or Perlane and will most likely last longer.

Good luck!

Jason R. Lupton, MD
San Diego Dermatologic Surgeon
4.3 out of 5 stars 7 reviews

Gaunt cheeks

For gaunt cheeks, I prefer Sculptra or even Radiesse. Fat grafting can be helpful as well. Sculptra was designed specifically for this reason. It requires multiple treatments, but usually does the trick.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.